What's on this Page
What is Tocainide
NOTE: This drug is discontinued in the US.
Tocainide is an oral, local anesthetic-type antiarrhythmic agent similar to both lidocaine and mexiletine.
Tocainide is categorized as a class Ib antiarrhythmic according to the Vaughan-Williams classification of antiarrhythmic agents and is used in the treatment of ventricular arrhythmias including unifocal and multifocal ventricular premature contractions, coupled ventricular premature contractions, and paroxysmal ventricular tachycardia.
It also has been used in certain types of neurologic diseases such as seizure disorders and pain associated with diabetic neuropathy.
However, tocainide can cause serious and potentially fatal hematological adverse effects.
Tocainide (Tonocard®) was approved by the FDA in November 1984.
Tonocard® tablets were discontinued on December 31, 2003; AstraZeneca has no further plans to manufacture or distribute Tonocard®.
Generic tocainide is not available.
Brand Name
Tonocard
Indications
- neuropathic pain
- ventricular tachycardia
For the treatment of sustained ventricular tachycardia that is deemed to be life-threatening
Side Effects
- abdominal pain
- agranulocytosis
- anemia
- angina
- anorexia
- anxiety
- arrhythmia exacerbation
- arthralgia
- ataxia
- AV block
- bradycardia
- bundle-branch block
- confusion
- constipation
- diarrhea
- dizziness
- drowsiness
- dyspepsia
- dysphagia
- eosinophilia
- fatigue
- hallucinations
- hearing loss
- heart failure
- hemolysis
- hypertension
- hypotension
- lethargy
- leukopenia
- myalgia
- myocardial infarction
- nausea
- neutropenia
- night sweats
- nystagmus
- palpitations
- pancreatitis
- paresthesias
- pericarditis
- pneumonitis
- premature ventricular contractions (PVCs)
- pulmonary edema
- pulmonary embolism
- pulmonary fibrosis
- QT prolongation
- rash
- respiratory arrest
- restlessness
- sinus tachycardia
- stomatitis
- thrombocytopenia
- tinnitus
- tremor
- ventricular fibrillation
- vertigo
- vomiting
Monitoring Parameters
- CBC
- ECG
Contraindications
- amide local anesthetic hypersensitivity
- AV block
- bone marrow suppression
- breast-feeding
- cardiac arrhythmias
- children
- dialysis
- geriatric
- heart failure
- hematological disease
- hepatic disease
- pregnancy
- pulmonary disease
- pulmonary fibrosis
- renal disease
- renal failure
- renal impairment
Interactions
- Bupivacaine; Lidocaine
- Cimetidine
- Colesevelam
- Dofetilide
- Hydrochlorothiazide, HCTZ; Propranolol
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Lacosamide
- Lidocaine
- Lidocaine; Prilocaine
- Moricizine
- Propranolol
- Rifampin
- Rifapentine
